MSIF Issues New Recommendations to Protect Against COVID-19

by Ed Tobias | November 13, 2020

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The Multiple Sclerosis International Federation (MSIF) has issued new recommendations about how people with MS should adjust their daily lives because of the coronavirus pandemic.

The MSIF, a network of national MS societies from around the world, first issued COVID-19 recommendations last spring. But much has been learned about the virus since then, including how it affects people with MS. The new recommendations address whether MS leads to complications with the virus, and whether it’s advisable to be treated with disease-modifying therapies during the pandemic.

Are people with MS affected differently than healthy people?

According to the MSIF, the answer is apparently not, although there are exceptions.

“The latest data is reassuring that people are not at a greater risk of contracting the virus or developing severe symptoms just because they have MS,” Clare Walton, head of research and access at MSIF, told me in an email.

But the updated recommendations add to the list of those with MS who are thought to have an increased risk of more severe cases of COVID-19. Previously, the list of those at higher risk included people with progressive MS, those with a score of 6 or higher on the Expanded Disability Status Scale, and people over 60. The new recommendations add to that men with MS, Black people and possibly South Asians with MS, people with MS who are obese or have diabetes, and those being treated with some disease-modifying therapies.

DMTs and COVID-19

An MSIF press release describes one change regarding disease-modifying therapies as “critical.” Some research indicates that DMTs targeting CD20 cells — specifically, ocrelizumab and rituximab — appear to be linked to an increased chance of someone with MS being hospitalized or requiring intensive care treatment if infected with the virus.

On the other hand, preliminary evidence indicates that interferons may reduce the need for hospitalization due to COVID-19.

Natalizumab has been moved into the group of DMTs considered to have no apparent risks.

Overall, the guidelines still recommend that “people with MS currently taking DMTs continue with their treatment, unless advised to stop by their treating clinician.”

Those who have tested positive for COVID-19, or who have begun to show symptoms, should discuss MS therapies with their healthcare provider, the guidelines state.

General recommendations

We should all be familiar by now with basic COVID-19 advice for the general public, such as the importance of wearing a mask, washing your hands, and social distancing. In terms of the latter, the federation states that people should follow national guidelines in their home countries.

Also, the MSIF states that people receiving high-dose steroids should socially isolate for one month because evidence shows they are at a higher risk of more severe COVID-19.

What about a vaccine?

With the hopeful news that a COVID-19 vaccine could be close at hand, the question arises about whether people with MS should be inoculated. The MSIF recommendations only say there’s not yet enough information about how a vaccine might interact with MS or the various DMTs to be certain. This advice will be included in an update as soon as it becomes available.

Would you take a COVID-19 vaccine if approved by health authorities? Please share your thoughts in the comments below, but let’s leave politics out of the answers. Consider it only from a health perspective. You’re also invited to visit my personal blog at www.themswire.com.

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.

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About the Author

Ed Tobias People say to write what you know and Ed Tobias knows about MS. He's lived with the illness since 1980, when he was 32 years old. Ed's a retired, award-winning broadcast journalist and his column combines his four decades of MS experiences with news and comments about the latest in the MS community. In addition to writing his column, Ed is one of the patient moderators on the MS News Today Facebook, Twitter, and Instagram sites. He’s also the author of “The Multiple Sclerosis Toolbox: Hints and Tips for Living with M.S.” Ed and his wife split their time between the Washington, D.C. suburbs and Florida’s Gulf Coast, trying to follow the sun.

Comments

DEBRA SMITH

Would you take a COVID-19 vaccine if approved by health authorities? Probably not until I have seen positive results and discussed/considered any side effects with my GP and/or my MS nurse. I'm okay at present and any past changes in my medication have tended to result in me feeling worse not better. I have SPMS & use a wheelchair, but I am generally fit and have always been healthy (apart from MS).

M Conrad

Re would I take the vaccine if one were approved...yes absolutely, in a heartbeat.

Belinda K Love

I have been taking Ocrevus every 5 months, but my neurologist suggested during this covid19 time that I should move it to 6 months. Thank you for confirming that delaying my infusion was the right decision.

Please stay safe, and continue to inform us with good info. Thank you.

Ed Tobias

I'm glad the info is useful to you, Belinda.

Thanks for being one of my readers and taking the time to drop a note.

Penny-Marie Wright

I recently saw my neurologist & he says I'm at no more risk of getting Covid-19 than him or anyone else who are healthy. I have felt that I'm immune compromised because I not only have MS but also have Fibromyalgia now too but he says "no, I'm not". I still worry though. I think I would hold off getting the vaccine a bit though until I see how it affects others.

Ed Tobias

Hi Penny-Marie,

What your neuro told you is what all of the data indicates, so far. Remember, people with MS have overactive immune systems that attack parts of our central nervous systems. Some of our disease-modifying treatments compromise the immune system in order to knock out those attacking cells and replace them with ones that are normal. So, as the MSIF recommends, people should be discussing that with their neuro.

Doctors don't yet know if there will be any interaction between a COVID-19 vaccine and people with MS, especially since there are several versions of a vaccine being developed. But the general feeling that I've read is that, as long as the vaccine isn't "live" - and I think most in development are not - there shouldn't be a problem.

Karen Strube

Thank you for this information. As a person with ms and a healthcare provider I would be one of the first to be vaccinated - this is a big concern for me and I could be mandated to receive the vaccine. My concerns are what might be the interactions with the vaccine and my current DMT (Aubagio, just switched from Betaseron) and how this autoimmune disease might react to the vaccine. I feel the vaccine has been rush to production ( yes we need it), I would like to see more testing prior to it being required. As we well know there have been many medications that have been pulled off the market following significant side effects.

Ed Tobias

Thanks for your comments, Karen, and for sharing your concerns.

I have to believe that health officials (the FDA in the US) will not approve a medication without being certain of its safety and its efficacy. I also believe that nobody will be forced to receive this vaccine, although I also believe there are times that a vaccination should be required for the good of the group, e.g. the requirement for MMR vaccinations for children to enter public school.

I tip my hat to you as a healthcare provider. We'll continue to provide as much information as we can about how COVID-19 affects MS and the DMTs we use.

Kathy Marzion

Diagnosed at 47. I just in the past 2 years have started meds. I consider my self blessed. I recently have had an episode that was the worst one I have ever had. I read every single thing I find on MS. I also belong to a group of warriors. I like your news letter. Thank you!

Ed Tobias

I'm glad you like what we write, Kathy, and I wish you the best with your MS.

Chuck

Yes, I would take the vaccine. However, I would have to get the input from my neurologist first. I’m on Ocrevus and still a bit nervous about this whole COVID thing. Ok, more than nervous...

Tammy Showell

The vaccine is now being distributed. I am a healthcare professional eligible to receive the vaccine soon, I am on Tier 1C, so it could be a matter of weeks when I have to make that decision.

I take the DMT Aubagio. My reading warns of live vaccines only. I must admit, I am still nervous about the risk. It's so early 'in the game'. I don't want to be a guinea pig. At this time, I do not know if or when I will take the vaccine.

Ed Tobias

Hi Tammy,

I'm hearing similar thoughts from some other health care professionals who live with MS. The latest info from MS groups indicates that it should be safe to take the vaccine, at least the mRNA formulations, but it's best to discuss it with your neuro.

The most recent info is in this column, which is more recent than the one on which you're commenting.

http://multiplesclerosisnewstoday.com/columns/2020/12/07/covid-19-vaccine-people-ms/

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MSIF Issues New Recommendations to Protect Against COVID-19